About healthycaregiver

I took care of my husband for 10 years while he had earlier-onset Alzheimer's disease. My experience, along with my expertise as a wellness coach and health writer, prompted me to write a book on how caregivers can maintain their health, increase energy, and experience peace. My book "Calmer Waters: The Caregivers' Journey Through Alzheimer's and Dementia" will be released in June, 2016 by Cardinal Publishing Group. Please follow my blog for caregiving advice and the latest scientific studies on staving off dementia and supporting cognitive function.

When your loved one has difficulty eating

senior woman eatingMeals can be challenging for someone with Alzheimer’s or another form of dementia, not to mention their caregivers. As the disease progresses, it can become difficult for the person to consume enough calories to maintain a healthy weight. But there are ways to encourage healthy eating. Eventually, toward the end of life, it’s natural for humans, and all animals, to lose the desire for food.

As his Alzheimer’s progressed, my husband, had trouble recognizing food items. Morris forgot how to hold a sandwich, and I’d have to place it in his hand. He forgot how to cut his food, so I served it to him already cut into small pieces.

Once when I handed him a sandwich to eat, he asked what it was. I replied, “Chicken salad.” He threw the sandwich across the table and exclaimed, “This chicken is dead!” It was hilarious, and shocking.

But there are ways to encourage your loved one to enjoy food and get good nutrition throughout most of the course of the illness.

Here are some suggestions:

  • Seniors and elders with health issues tend to be hungriest in the morning and eat less as the day progresses. Make a healthy breakfast packed with protein, healthy fat, antioxidants, vitamins and minerals. Eggs, anywhere you like them, served with avocado, toast, beans, and  greens provides everything needed to establish the beginning of a good day. The same goes for caregivers! You need the strength and energy to get through the day, so start it off with a nutrient- rich breakfast.
  • Setting the table–Put as little on the table as possible in order to not confuse the patient or detract for their ability to clearly see what is in front of them. Use a colorful plate mat, and a white plate so the food stands out. And serve colorful foods, which are higher in antioxidants and vitamins and minerals. Think sweet potatoes, winter squash, corn, beets, greens, etc. Root veggies can be pureed and served in a mash, which is easier to chew and swallow.
  • Make sure the environment is clean and pleasing. Put on some favorite music. It can be stimulating or soothing, depending on the mood.
  • Has the patient kept up with their dental appointments? My mother was always fastidious about dental care, visiting her dentist several times a year for cleanings. But at the end of her life, she began to lose teeth, most likely from poor nutrition. Observe your loved one and make sure there are no signs of pain, grimacing, trouble chewing, etc.
  • Sometimes, a person will not remember that they have eaten just a little while before saying, “When is lunch (or dinner)?” Or, “I’m hungry. When are we going to eat?” Leave their plate on the table longer as a visual reminder. You might have to hide food, if they have the tendency to overeat. And if you want to make sure they, as well as you, are eating the best diet possible, refrain from buying cookies, sweets, chips, and crackers, that are filled with empty calories and hydrogenated fats.
  • Provide a meal companion for your loved one. If you can’t eat with him/her, ask a friend to share a meal. Or, if he/she is still able to eat in a restaurant, have a friend make a weekly lunch date and bring them to a quiet restaurant that serves their favorite food.
  • The taste for sweet things is the last one to go. If your loved one doesn’t have any appetite, it’s almost guaranteed that they will enjoy ice cream. There are lots of options on the market to choose from ranging from traditional ice cream to frozen desserts made with cashew cream, coconut cream and soy milk.
  • Make sure the temperature of the food isn’t too hot or too cold, and that the patient is seated comfortably in a room that is neither too hot or cold.

Dysphagia

Dysphagia is any problem with swallowing. This was a major issue for my dear mother, who, at the end, couldn’t eat without the food going into her lungs instead of her stomach. In determining the extent of dysphasia, the patient does a swallow test drinking liquid of various consistency and thickness.

Food and drink categories

  1. Nectar thick, he consistency of nectar, quickly runs off a spoon
  2. Honey thick, the consistency of honey, slowly drips off a spoon
  3. Pudding thick, the consistency of pudding, plops off a spoon

My mom had to drink water that was thickened, which tasted disgusting. As a result, she often refused to drink and once became dehydrated to the point where she was hospitalized.

If your patient is put on a dysphagia diet, experiment and find ways to keep him or her hydrated. Puree their favorite foods, make shakes that are delicious and nutritious. You can puree just about anything and make it taste good with herbs, tomato sauce, etc. Please don’t add salt. Yogurt and puddings are another good option. Read the labels and try to avoid added sugars. Especially watch out for high sugar content in flavored yogurt.

Poor appetite

If your loved one doesn’t want to eat, accept it as the course of the illness. But if they are still walking and reasonably active, rule out contra-indications of newly administered drugs and illness, such as urinary tract infections.

Additionally, your patient might have a poor sense of smell, which will translate into a poor appetite. Try adding more seasoning to the food, but try to avoid salt and use herbs and spices that include antioxidants such as thyme, basil, oregano, cumin, cinnamon, and cardamom.

Laraine Pounds, R.N., an internationally recognized aromatherapist lists aromatherapy essential oils that stimulate appetite in chapter 18 of my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.”

Eating issues are common amongst individuals with dementia. Experiment with these suggestions and see what makes a difference. Sometimes, just sitting next to someone and offering gentle conversation helps.


 

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

10 New Year Resolutions for Caregivers

2020 New year concept. Goals list in stationery, blank clipboard, smartphone, pot plant on pink pastel color with copy spaceYou’re tired, you’re stressed–You and 45 million or so American caregivers. So what are you going to do about it? Don’t say that “I don’t have time to take care of myself.” I’ve been there and done that. But I always promised myself that I was not going to be a martyr and sacrifice my health for my husband’s illness. Because if both of us went done that wasn’t going to serve any purpose, least of all our children. They were barely adults when my husband was in the throes of Alzheimer’s disease. They needed at least one healthy parent. And whether you are taking care of a spouse, parent or child, there are other people in your life who love and need you, not necessarily to take care of them, but to love and support them emotionally.

When you are a caregiver, it’s hard to find the time to go to the gym or even take a shower, somedays. But it’s absolutely vital that you take care of yourself or you will end up getting sick and then who will take care of your loved one? Who will take care of YOU?

Here are 10 easy ways to take the edge off your stress and fatigue so you feel some relief.

  1. Say a positive affirmation before you get out of bed. “This day is going to be a good one.” “I am grateful for my friends and family.” “I am healthy and full of energy.” “I am strong and competent.” Say something positive to set the tone of the day.
  2. Before you reach for a cup of coffee, drink a glass of hot water with lemon. It hydrates your body and brain, the lemon helps to alkalize the system (yes, it’s counter intuitive), which is usually too acidic, and it helps with regularity.
  3. Ask for help! You don’t have to do it all by yourself. No one is going to think badly of you if you take some time for yourself. If your loved one resents your going out, it’s okay. Don’t become a slave to their wishes and rants. If you can’t leave your loved one alone, please ask a neighbor, friend or home care professional to help at least a couple hours a week. Some social service programs provide free respite care.
  4. Many cities throughout the U.S. offer volunteer snowbusters (volunteers who will shovel your walk and driveway), fix-it volunteers who will help with easy home repairs, and yard maintenance volunteers.
  5. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  6. Find a walking partner in your neighborhood and try to walk at least once a week (preferably 3 times a week).
  7. Put on a CD, vinyl record or the radio and listen to your favorite music. If your care partner is mobile, ask him/her to dance. There is nothing like music or dance to uplift the spirit.
  8. Use essential oils to immediately diffuse feelings of sadness, depression, anxiety, etc. Lavender oil is the most frequently used fragrance. You can also try bergamot, grapefruit, lemon, orange, clary sage, geranium, rose, and ylang ylang, frankincense, and myrrh. Put the oil in a diffuser or spray bottle to mist your collar or pillow. Find a fragrance that is pleasing to your care partner. It’ll help him/her also.
  9. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  10. It’s important to get at least 6 hours (preferably 7 or 8) of sleep every night. Of course, this isn’t always possible if you are caring for someone and need to get up at night, or are worried about paying the bills, taking care of the car, getting a new stove, etc. If you can’t get in the hours at night, put your feet up for 10 minutes during the day when your care partner naps. Or take a power nap. It really helps.

Wishing you and your loved ones a healthy, happy New Year! And remember that “this too shall pass.”

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

High blood pressure is a risk for (MCI) mild cognitive impairment

Close up of digital monitor device with cuff showing high diastolic and systolic blood pressureDid you know that high blood pressure puts you at risk for developing Mild Cognitive Impairment (MCI)? The problem is, MCI can eventually develop into dementia and Alzheimer’s disease.

A recent study involving 9,400 adults that was published in JAMA (January 28, 19) indicates that you can reduce your risk of MCI by lowering your blood pressure.  Adults in their 50s or older with high blood pressure participated in a clinical trial led by scientists at the Wake Forest School of Medicine in Winston-Salem, NC. The purpose of the trial was to evaluate the effect of blood pressure control on risk of dementia. The participants received either intensive blood pressure control or standard treatment.

Intensive control was used to bring systolic blood pressure below 120 millimeters of mercury (mm Hg), while the purpose of standard treatment was to lower it to under 140 mm Hg. Systolic blood pressure is the pressure in the arteries when the heart contracts. It is the top number in a blood pressure measurement, as in 120 mm Hg over 70 mm Hg.

The results revealed that significantly fewer of those who received intensive blood pressure control went on to develop Mild Cognitive Impairment, compared with those on the standard treatment. The lead investigator Dr. Jeff D. Williamson said that “three years of lowering blood pressure not only dramatically helped the heart, but also helped the brain.”

However, the study did not show that intensive blood pressure control reduced the incidence of dementia. The authors suggested that low numbers and the study finishing earlier than planned could be reasons for this.

What is Mild Cognitive Impairment? 

MCI is a condition in which the individual has some loss of mental acuity, such as forgetting appointments, losing the flow of a conversation, and difficulties making decisions and keeping track of finances, as well as trouble with reasoning. The individual is still able to care for him or herself and live a fairly normal life.

Approximately 15 to 20 percent of people 65 and older have MCI. People living with MCI are more likely to develop Alzheimer’s disease or other dementias. But MCI doesn’t always lead to dementia. In some cases, MCI remains stable or resolves on its own. Some medications may result in symptoms of MCI, including forgetfulness or other memory issues.

There are no pharmaceutical drugs approved in the U.S. for the treatment of MCI. However, the study discussed above, is a good indication that high blood pressure that is controlled through changes in lifestyle can help prevent MCI.

Why is high blood pressure dangerous?

It’s called the “silent killer” because it is insidious. It often has no warning signs or symptoms.

If your blood pressure is high it causes strain on the vessels carrying blood throughout your body. This can injure the vessels and lead to plaque buildup as a response to injury. Eventually, this can lead to narrow blood vessels and then clotting of passageways, which can cause damage to the heart and/or brain. High blood pressure ultimately increases your risk for getting heart disease, kidney disease, dementia, and for having a stroke.

Taking Your Blood Pressure

When your doctor takes your blood pressure, he/she is measuring the pressure in your arteries as your heart pumps. The heart contracts and relaxes during each heartbeat. When it contracts, the blood is being pumped out of the two ventricles (chambers) and your blood pressure goes up. Systolic pressure (the top number in the blood pressure reading) is the peak reading of the pressure produced by this contraction.

When the heart relaxes, blood fills the ventricles and your blood pressure goes down. The diastolic pressure (the bottom number in the blood pressure reading) measures the pressure between the beats as the heart relaxes.

What’s normal blood pressure?

High blood pressure used to be considered 140/90 or higher.

According to the National Heart, Lung and Blood Institute (a division of the Institutes of Health), normal blood pressure is now considered to be lower than 120/80 according to the guidelines released in November 2017.

The guidelines state that for BP above 115/75, every rise of 20/10 mm Hg doubles the risk of cardiovascular disease. Since 2017, the American Heart Association has advised that people with high BP should receive treatment at 130/80 rather than 140/90.

In the new guidelines, the AHA also recommends that doctors only prescribe medication in cases of a previous heart attack or stroke, or in the presence of risk factors such as: age, diabetes, or chronic kidney disease. Rather, at the earlier stages of hypertension, another word for high blood pressure, patients should make lifestyle changes. Here are a number of ways to do that:

10 Ways to support healthy blood pressure and prevent MCI

  1. Eat a nutritious, high-fiber, low-fat heart healthy diet. Learn about the MIND diet.
  2. Beware of your intake of sodium.
  3. Include foods high in phytonutrients—fruits and veggies.
  4. Take nutritional supplements proven to support a healthy heart: magnesium, potassium, B vitamin complex, vitamin D3, CoQ10, Grape seed extract, Resveratrol, Quercetin.
  5. Avoid decongestants if possible. These drugs can raise blood pressure.
  6. Practice a stress reduction technique such as yoga or meditation.
  7. At the minimum, take a walk 3-4 times a week.
  8. Stop smoking and reduce consumption of alcohol.
  9. Drink 6 to 8 glasses of water every day.
  10. If you snore, have sleeping problems, or are sleepy during the day, discuss sleep apnea with your physician.

Give yourself the gift of peace and get plenty of rest and sleep.

Happy Holidays!


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

30 Tips for Coping with Holiday Grief

candle lightThe holidays can bring up all sorts of emotions: joy, anxiety, depression and grief, especially if you’re missing a loved one, or if a loved one is a shadow of their former self.

You are entitled to feel any and all emotions as they arise. If you’re at a holiday party and the tears well up, simply excuse yourself until you’re ready to rejoin the group. If you’re overcome with fatigue and grief and simply can’t make it to a party, it’s okay. Make yourself a bowl of popcorn and watch a movie or read a book. But keep in mind that socializing might do you a world of good. The most important thing is that you do what’s best for YOU. So whatever you need to do in order to get through the holiday season, do it in a healthy way. Please don’t rely on alcohol or drugs to numb your feelings.

Here are some suggestions for feeling your emotions and feeling your best, while remembering your loved ones during the holidays and beyond.

  1. Be honest with yourself and with others. Tell them what you’d like to do and what you’d prefer not to do.
  2. Create a new tradition in honor of your loved one, i.e. if you typically hosted a dinner, set a place setting and serve your loved one’s favorite dish.
  3. Decide where you want to spend the holidays. Maybe go to a new place or take a trip with another widow or widower whom you met in a support group.
  4. If you’ve had a hard time discarding your loved one’s clothes, think about donating them to a homeless shelter, etc.
  5. Start journaling. It’s a wonderful way to express your feelings and get things off your chest.
  6. Write a letter to your loved one and express your love, your sadness, grief, guilt, etc.
  7. Place two chairs facing one another. Sit in one and speak out loud the words you would like to express to your loved one. Tell him or her how much you miss them, or express your anger and guilt, etc.
  8. Watch what you eat. You should definitely enjoy your favorite foods, but don’t use grief as an excuse to overindulge in foods that aren’t good for you.
  9. Splurge on a gift for yourself!
  10. Help out at a shelter or food bank, or make a donation in honor of your loved one.
  11. Don’t overcommit. You don’t need to make the holiday meal, if you’re not up to it.
  12. It’s okay to be happy. It’s the holidays! Don’t feel guilty for enjoying yourself. It won’t diminish the love you have in your heart for your loved one.
  13. Read a book that will help identify your feelings and cope more easily with grief. I recommend these two: The Empty Chair: Handling Grief on Holidays and Special Occasions by Ed.D Zonnebelt-Smeenge, Susan J. R.N. and Robert C. De Vries | Sep 1, 2001. The Secret Life of Grief: A Memoir by Tanja Pajevic, 2016, 2016
  14. Get a massage.
  15. Use aromatherapy. Citrus oils are generally refreshing and uplifting for the mind and emotions, relieve stress and anxiety.  Consider: bergamot, grapefruit, lemon, and orange. Floral oils are often used as a personal fragrance and are useful to relieve anxiety, depression, and irritability. These oils are useful as an inhaler, in a body lotion, and for the bath. Consider: clary sage, geranium, lavender, rose, and ylang ylang.
  16. Get the sleep that you need.
  17. Make an appointment with a professional therapist if you need help.
  18. Eat a serving of high-quality protein with every meal and snack
  19. Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  20. Enjoy unlimited amounts of fresh veggies.
  21. Eat a good breakfast!
  22. Eat 3 balanced meals and 1-2 snacks/day.
  23. Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  24. Meditate, light a candle, or find some quiet time for yourself.
  25. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  26. Exercise! At least take a short walk every day.
  27. Put on a CD, vinyl record or the radio and listen to your favorite music. Dancing as though no one is watching. There is nothing like music or dance to uplift the spirit.
  28. Put on a funny YouTube video and laugh.
  29. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  30. Do the best you can. Try to relax and enjoy your family and friends.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

A Vegetarian Holiday Feast

Homemade apple pie with nuts and pumpkin seeds.I’ve been a vegetarian since 1971—my entire adult life. I’ve never had a problem eating Thanksgiving dinner. I just avoid the turkey and make a veggie dish containing protein. The benefit is that, although tryptophan—the essential amino acid in turkey—won’t be surging through my body to promote serotonin, the feel-good neurotransmitter—I will be getting more antioxidants and fiber than most people enjoying the holiday feast.

Whether you eat turkey or not, are a vegetarian or not, here are some great veggie dishes worth trying. I’ve listed them in order from appetizer, salad, muffins, entree, side dishes, and dessert to make a complete vegetarian Thanksgiving/holiday feast.

These two appetizer recipes are a throwback to the 70s. They are still delicious! Serve before your feast, while you are busy in the kitchen with final preparations. All recipes are gluten-free except for the pumpernickel dip, which can be made gluten-free if the dip is put into a bowl or gluten-free hollowed out bread.

Appetizers

Artichoke Dip

  • 1 can artichokes, drained and cut into small pieces.
  • 1 cup mayonnaise
  • 1 cup Parmesan cheese
  • 1/4 tsp garlic powder

Directions

  1. Blend all ingredients together.
  2. Sprinkle paprika on top. Bake at 350 for 20 minutes.
  3. Serve with crackers, veggies, etc.

Pumpernickel dip

  • 3 cups sour cream (1 large container) or plain Greek yogurt
  • 3 cups mayonnaise
  • 4 tsps dried dill weed
  • 1 tsp. salt (or to taste)
  • 1 tsp. celery seed
  • 4 Tbs. dried onion flakes
  • 4 Tbs dried parsley flakes

Directions

  1. Blend together and refrigerate overnight or for several hours so flavors blend.
  2. Scoop out the center of a round pumpernickel or sour dough bread. Fill with the dip.
  3. Serve with raw veggies that can be dipped into the bread.

Salad

Green salad with “cutie” mandarin oranges—serves 4-6

  • 1 or 2 heads of Butterhead lettuce
  • 3 mandarin sectioned oranges or 1 can of mandarin oranges, drained
  • 1/2 cup slivered almonds
  • 2 Tbs sugar
  • 1 cup celery, diced
  • sliced red onion (optional)

Dressing

  • 1/4 cup red wine vinegar
  • 1/2 cup olive oil
  • 1 tsp sugar
  • salt and pepper to taste
  • 1/8 tsp red pepper flakes

Directions

  1. In a large bowl, combine the lettuce, oranges, and sliced onions.
  2. Heat sugar and almonds in a pan over medium heat until sugar melts and coats almonds; stir and heat until almonds are slightly brown.
  3. Turn onto plate and cool for 10 minutes.
  4. Combine remaining ingredients in a jar with a tight fitting lid; shake vigorously.
  5. Pour salad dressing over lettuce mixture; toss.
  6. Sprinkle with sugared almonds.

Muffins

Gluten-free Flax Meal Muffins

  •  ¾ cup brown rice flour
  • ¾ cup buckwheat flour
  • ½ cup ground flaxseed
  • ½ cup date sugar (or sweetener of your choice)
  • 1 tsp baking soda
  • ½ tsp ground cinnamon
  • ¼ tsp ground nutmeg
  • ¼ tsp salt
  • ½ cup raisins
  • 2 eggs
  • ¼ cup oil of your choice (coconut, avocado, etc.)
  • 1/2 cup unsweetened applesauce
  • 1 cup buttermilk or coconut milk

Directions

  1. Preheat oven to 375º. Line a 12-cup muffin tin with unbleached paper liners and set aside.
  2. In a large bowl, whisk together brown rice flour, buckwheat flour, flaxseed, sweetener, baking soda, cinnamon, nutmeg, salt and raisins.
  3. In a second large bowl, whisk together eggs, oil, applesauce and buttermilk. Add flour mixture to buttermilk mixture and stir until just combined.
  4. Spoon batter into prepared muffin tins and bake until golden brown and a toothpick inserted in the center of a muffin comes out clean, about 30 minutes.
  5. Cool muffins in pan for 5 minutes before transferring to a wire rack to finish cooling.

Entree

Kale Slab Pie (adapted from a recipe by Arthi Subramaniam)  serves 12

  • 3 bunches of kale—tear the leaves off the stems, or 2 pounds of Swiss chard
  • 1/3 cup olive oil
  • 2 medium onions, finely chopped
  • 1 bunch scallion, chopped
  • 1/2 cup chopped fresh dill
  • 1/2 cup chopped fresh mint
  • 1 tsp red pepper flakes
  • Freshly ground pepper to taste (divided)
  • 3 cups water
  • 2 cups coarsely ground cornmeal (polenta style)
  • 1 cup feta cheese, crumbled
  • 1 cup shredded mozzarella cheese
  • 1 cup pomegranate seeds for garnish

Directions

  1. Blanch kale leaves in salted boiled water for about 4 minutes. Transfer wilted greens to a bowl of cold water. Drain and squeeze out moisture. Chop and set aside.
  2. Heat 4 Tbs of olive oil over medium heat in a skillet, add onion. Cook, stirring until tender, about 8 minutes.
  3. Add scallions and cook for another 2 minutes. Stir in kale, dill and mint. Add red pepper flakes, and salt and pepper to taste, and combine well. (I don’t add salt because I think there’s another salt in the cheese.) Remove from heat and let kale mixture cool.
  4. Preheat oven to 350 degrees and grease a 13-by-9pinch rectangular pan with remaining oil (1 Tbs plus 1 tsp.)
  5. In a medium saucepan, bring water to a boil. Gently and slowly add polenta and 1-2 tsp. of salt. Stir continuously so it doesn’t lump until thick. Spread in the pan, like a crust.
  6. Add feta and mozzarella cheese to kale mixture; lightly combine well. Spread evenly over the polenta crust. Cover the dish with foil, loosely, and bake 30 minutes. Remove foil and bake an additional 15-20 minutes, until top is slightly brown. Remove from oven and allow to sit for 30 minutes. Garnish with the pomegranate seeds. Allow the slab pie to “rest” for about 30 minutes before serving.

Veggie side dish

Roasted Cauliflower  serves 6

  • 2 heads cauliflower cut into florets
  • 1/2 cup olive oil
  • 1 tsp dried thyme
  • 1/2 tsp salt
  • 1/2 tsp pepper
  • 2 Tbs pine nuts
  • 1/2 cup raisins soaked in hot water

Directions

  • Preheat oven to 450 degrees.
  • In a large bowl, toss cauliflower, 1/4 cup olive oil, curry powder, salt and pepper. Spread onto a pan and roast for 10 minutes. Toss and then roast another 10 minutes until slightly golden, about 2 minutes.
  • Toast the pine nuts in a toaster oven, making sure to keep an eye on them so they don’t burn. Drain the raisins. Toss the cauliflower with the pine nuts and cauliflower.

Side dish

Butternut Squash Risotto serves 4

  • 1 butternut squash baked and scooped
  • 2 Tbs olive oil
  • 1 tsp salt
  • 1/2 tsp black pepper
  • 6 cup of vegetable stock or water
  • 6 Tbs unsalted butter
  • 2 large shallots, minced
  • 1 1/2 cups of Arborio rice
  • 1/2 cup of white wine
  • 1 tsp saffron threads
  • 1 cup of grated parmesan
  • Heat oven to 450 degrees. Peel squash and cut into cubes, discarding stringy center and seeds. Toss with olive oil and salt and pepper. Place on baking sheet and roast 30 minutes. Set aside.

Directions

  1. Heat stock and simmer.
  2. In a large pot, melt butter and add shallots for 10 minutes. Add rice and coat with butter.
  3. Add wine and cook 2 minutes.
  4. Add 2 full ladles of stock to rice plus saffron, 1 tsp. salt and 1/2 tsp pepper. Stir and simmer until stock is absorbed. Continue to add stock until almost all is used, cooking about 30 minutes.
  5. Turn off heat and add squash and Parmesan cheese.

For dessert enjoy apple pie, pumpkin pie or simple baked apples with ice cream.

Baked apples

Ingredients

  • 3 pounds apples peeled, cored, sliced (Honeycrisp, Gala, or Granny Smith, or a mixture of 2 or all 3)
  • 1/2 cup light brown sugar
  • 2 teaspoon ground cinnamon
  • 1/2 teaspoon ground nutmeg
  • 1/4 teaspoon ground cloves
  • 1/8 teaspoon salt
  • lemon juice from 1/2 a lemon
  • 1 teaspoon vanilla extract
  • 2 tablespoons unsalted butter

 

Directions

  1. Preheat the oven to 350 degrees.
  2. Peel the apples, cut and remove the core and cut into slices about 1/3-1/2 an inch thick.
  3. Put the apples to a large bowl and add the light brown sugar, cinnamon, nutmeg, cloves, salt, lemon juice and vanilla extract. Stir to combine. Spoon the apples into a 2 quart baking dish.
  4. Cut the butter into small squares, and place over the apples.
  5. Bake for 30 minutes, stirring after the apples have baked for 15 minutes. This prevents apples on the top from drying. Bake until the apples are tender and soft.
  6. Remove and serve with a scoop of vanilla ice cream on top. Serve warm.

Have a safe and wonderful Thanksgiving!

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and online at Target and Walmart, and many other fine independent bookstores, as well as public libraries.

10 Great Gifts for Caregivers

New Year's box with gifts and bows, fir cones, snowflakes and Christmas toy on old boardsIf you’re a caregiver, you have little time for yourself and you’re probably stressed out. You don’t need another pair of pajamas, and you don’t need another coffee mug.

What you desperately need is some time for yourself to relax and rejuvenate, and ways to make your life easier.

When friends and family ask you,” How can I help?” Or, “What do you need?” send them this list. They will appreciate it, and you will definitely appreciate the rewards.

  1. You know how wonderful it feels to have a sparkling clean house. And you probably haven’t had time to do a deep cleaning in a while. Ask your friends and neighbors for recommendations for a good house cleaner or cleaning service. Merry Maids is a national company available in most parts of the U.S. They also have gift cards online to make it convenient for your gift givers.
  2. Wouldn’t it be heavenly to get away for a few hours? It’s important to maintain friends throughout our lives, and even more important when we need to vent or just need a friendly chat or someone to tell you that you’re doing the best that you can. Gift cards to a neighborhood coffee shop or restaurant can help provide an excuse to connect to a friend you haven’t seen in a while. Make a date.
  3. But in order to make a date, you might need a companion to stay with your loved one. Providing TIME to you may be the greatest gift of all. Ask for a time donation, possibly in blocks of time. Two hours a week for a month? Four hours a month? Spread your wishes around. You’re bound to get several “yeses.”
  4. Do you like to sing? Whether you sing in the shower or in a chorus, it’s been well documented that singing reduces stress levels and depression. Group singing boosts oxytocin levels, and creates a feeling of “togetherness.” (Oxytocin is called the “love  hormone” because it is released when mothers breastfeed and when people snuggle up or bond socially. Request a favorite music CD that you like to sing to. Try to include the person you are caring for. Invite neighbors over for a singalong, and make it intergenerational. It’s amazing that people who even have advanced dementia can often remember the words to songs they sang decades ago.
  5. What about dance? You might have two left-feet, but you can dance away your blues without anyone watching in your living room. I always say that dance is what kept me off anti-depressant medication during the 10 years I cared for my husband. I did folk dance, salsa, and contra on a weekly basis. It was well worth the expense of hiring someone to keep my husband company on those evenings. Dance supports the release of endorphins from the brain into the bloodstream. I experienced firsthand a rush of happiness for hours, and sometimes days, after dancing for just a couple hours. Not only does dancing uplift your spirit, it can help you think more clearly. A 21-year-long Einstein Aging Study that was published in the New England Journal of Medicine in 2003 found that dancing is the best form of exercise to help prevent dementia when compared to 11 other activities including swimming, bicycling, and team sports. The study also found that dancing can help slow down cognitive decline. Dancing to music that carries special significance can be a wonderful way to connect with your care partner. Why not ask for a CD of your favorite music and dance in your living room, alone or with your care partner? Or, learn a new dance. Request a DVD to teach you the steps. Or, try a Zumba class. Fitness is a Latin-inspired cardio-dance workout that uses music and choreographed steps to form a fitness party atmosphere. While many of the types of dance and music featured in the program are Latin American inspired, classes can also contain everything from jazz to African beats to country to hip-hop and pop. Attend a Zumba class at your local recreation center or YMCA. They are also available on YouTube videos. And ask for a gift of companion-sitting for your loved one.
  6. House maintenance is often neglected when you have a million caregiving tasks. When is the last time you raked your lawn, pulled weeds, fixed a leaky sink, or had your carpets cleaned? The offer of someone volunteering their time to provide these services or the gift of a handyman service is always appreciated.
  7. Would you like to try a yoga class, either online or at a studio? Ask for a yoga mat, yoga blocks and a yoga strap. That’s all you need to help you release stress, build up endurance, relax muscles, and reduce risk of osteoporosis. Yoga videos are sold on Gaim, and are offered on their website for $11.99 per month after doing a free 2-week trial at https://www.gaia.com/yoga?utm_source=google+paid&utm_medium=cpc&utm_term=gaiam%20yoga&utm_campaign=1-USA-ENGLISH-BRAND-EXCT&utm_content=gaia&ch=br&gclid=Cj0KCQiA5dPuBRCrARIsAJL7oejWgk-kRRzIVjk_nt7xXY3-I5F_cYeHbltpDj4H7vba2QBjnQPwwiMaAqLVEALw_wcB
  8. Everyone loves a home-cooked meal. A personal chef who prepares meals in your home or theirs is an extravagant service. But put the idea out there. You never know . . . . A more affordable option is home-delivered meal kits. Home Chef, Blue Apron, and Green Chef are a few of the meal kit companies that allow you to choose meals that arrive with fresh, pre-measured and prepped ingredients, and instructions on how to create a fast meal.
  9. Massage is a wonderful way to relax and tune out the world. I highly recommend asking for a gift certificate to a spa that offers massage with hot stone and aromatherapy. You will emerge like a new person.
  10. One of the best gifts you could receive is respite care.  Do you have a relative or friend who could stay with your loved one a night or two so you can get away and totally tune out the world? If not, maybe one of they would generously provide you with a professional care service. Just imagine getting away from it all without any responsibilities for 24 or 48 hours.

You deserve gifts that will help you, the caregiver. So don’t be shy. When people ask how they might help or what you need or want, send them this list.

Have a happy, restful and peaceful Thanksgiving!


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Barnes & NobleBoulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and online at Target and Walmart, and many other fine independent bookstores, as well as public libraries.

What do you most remember/or miss about your loved one this Alzheimer’s Awareness Month?

christmas angel on blur bokeh city lights at night on background. Little white guardian angel in snow.As we honor our loved ones this Alzheimer’s Awareness Month of November, I invite you to submit:

  • a memory, poem, or tribute on how being a caregiver has changed your life
  • how having a loved one with Alzheimer’s disease has changed your life
  • a bit of advice that you’d like to share
  • just a memory

You can add it as a comment on this site, or send it to my email account and I will add it for you. Feel free to send a photo. calmerwaters410@gmail.com

I’d like to share something that my husband said to me three years before he passed away from younger-onset Alzheimer’s disease. This is in response to being asked what it’s like to have Alzheimers.

In Morris’s wordsMarch 2007

One time I feel one way and another time I feel a different way. I cope by finding things to do. I read, talk to people, go out to lunch with my friends. I feel just like anybody else, but I’m limited in things that I want to do, or where I want to go. I have to have someone take care of me. I would rather be my own person and do what I can do as much as possible. It’s not great having this [Alzheimer’s] and there’s not much I can do about it. But I do have lots of great friends and family, and I’m lucky to be able to think and act and live a partial life.

I’m not very happy at times. It’s not easy for me, and my wife tries to help as much as possible. I feel frustrated. I can’t have my car, which was taken away. I don’t have as many options. We have our TM lunch*; one of the things I look forward to. That’s a happy thing to do. Having people around is obviously good. I like watching movies and TV.

Sometimes I don’t know what to do, or I forget things and have to depend on my wife. I’ve had things taken away from me. When I first got the diagnosis, I thought it was a bunch of crap. I didn’t think the doctor had the right diagnosis and that I was pretty much okay. Now I understand that I have Alzheimer’s disease and things are more difficult. That’s the way it is. Having a support group is very important to me. Sometimes I get frustrated and sometimes I feel that I’m still a human being and that I can do things.

I know I’m taken care of.  I’m able to just be a good person that other people want to be around. I’m already enlightened in my own way. I feel like I’m my own being, my own person, and am living a life to the best of my ability. I like music and culture. I’m very lucky to have a support group of friends and family. In this life, I’m doing the best I can and I’ll continue to with friends and family.

I want to be treated like any other human being. My message to others is try to find your own happiness and do the best you can. I still like to meditate and I like to take a nap every day. I am getting more tired. I can’t do a lot or do as well as I used to do.

* About a dozen friends who practice Transcendental Meditation have been meeting regularly for lunch every Tuesday for the past 18 years.


This morning, I listened to an interview with the flutist Eugenia Zuckerman on NPR. Sadly, she was diagnosed with Alzheimer’s three years ago. This past September, Zukerman was playing Claude Debussy’s “Syrinx” — a piece she said that she’s played more than 20,000 times since the age of 10.  In the middle of playing it, she drew a sudden blank.

Eugenia said that she wants people to know that having cognitive decline is “not the end of the world.” At this early stage of the disease, she is able to write, play the flute, and enjoy her everyday life. Her recently published book “like falling through a cloud” is a lyrical memoir of poetry that addresses coping with forgetfulness, confusion, and a dreaded disease.

Eugenia spoke of living each day to the fullest—a definite mantra of mine and most people.  I am happy that she is enjoying her life by loving, sharing and playing her flute. But she doesn’t have a clue about what’s in her future. There will tragically come a time when her memory lapses manifest as blank stares. She may eventually not be able to recognize her face in the mirror and ask the existential question who am I? 

I wish you, and Eugenia’s family and friends peace and strength on the hard journey ahead. Make each day count and, as Morris said, live it as well as you can. There will be days that are hard to get through, and days where you just want to stay in bed. Even if you have to drag yourself out of bed, do at least one thing that will bring you an inkling of joy. Make a cup of chai, take an Epsom salts bath, light a candle. Take a whiff of your favorite essential oil. Remember the good times.

 


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Just because I’m having trouble with my short-term memory doesn’t make it OK to exclude me from discussions about me

Just because your loved one has dementia, please treat him or her as a thinking, feeling person who has feelings. Don’t disregard them or exclude them from conversation.

Dealing with Dementia

I’m writing this post recognizing that I’m really kinda angry. I know I can get a little “righteous” but I’m seeing families work around their loved ones instead of with them.

I know often, it’s easier to to just do things for someone. Please imagine how you would feel if you suddenly found yourself on the outside when choices about your health and finances were made for you?

Maybe you had a discussion about the topic, but for someone with short-term memory loss they won’t remember that, so are there other ways to help include and remind them of the discussion and decisions made? A notebook, email or texts?

I’m working with a new client and she told me she went to the bank to get a copy of her last statement and her son and POA had changed her statements to paperless. She knows she can’t recall the amount…

View original post 322 more words

Is it time to place your loved one on hospice care?

Elderly female hand holding hand of young caregiver at nursing home.Geriatric doctor or geriatrician concept. Doctor physician hand on happy elderly senior patient to comfort in hospital examinationDeciding if it’s time to place a loved one on hospice care is one of the most painful decisions any caregiver will make. After my mom broke her hip, she was put on heavy pain medication. I sat by her side for two weeks and witnessed her hallucinating about bugs flying in the air and seeing dead family members visit her. I thought they were coaxing her to follow them. I believed that she was dying, and her doctor advised me to consider placing her on hospice care. After talking it through with my brother, we agreed that this was the best thing to do.

Well, it ended up not being the best thing. The hospice team was giving her too many meds and my mother was dying from lack of hydration and food because her hospice caregivers were “snowing” her. They gave her too many pain meds and not enough liquids. She slept round the clock and didn’t wake up to eat or drink. When the private caregiver I hired me alerted me to what was going on, I took my other off hospice. She bounced back and lived another couple of years. She never walked again, despite making a whole hearted effort (that’s another story) and welcomed three great grandchildren into the family.

Several years before my mom died, she placed my dad on hospice care. He had an entirely different experience. The hospice team attentively provided care that my mother was incapable of, and he died with dignity.

The day my husband’s doctor suggested that I consider hospice care was a hard one. But I knew that his illness was terminal, and welcomed the extra attention and care that he would receive. At the very end, the loving and tender care that the hospice team showed him and me and my adult children was significant and so appreciated. They provided us with food and beverages, and aromatherapy cream to massage his legs and feet.

Whether your patient has a terminal illness, is getting toward the end of life, or is suffering from acute and painful symptoms, it’s important to know the difference between palliative care and hospice.

Palliative care

Palliative care is an umbrella of comfort and quality of life care which includes hospice care. It isn’t just used at the end of life, but can be very beneficial when the goal is complete healing and cure. Palliative care is not only end-of-life care. It can be used anytime during the course of an illness.

Defined by the National Hospice and Palliative Care Organization, “palliative care is patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information and choice.”

The following points characterize palliative care philosophy and delivery:

  • Care is provided and services are coordinated by an interdisciplinary team.
  • Patients, families, palliative and non-palliative health care providers collaborate and communicate about care needs.
  • Services are available concurrently with or independent of curative or life-prolonging care.
  • Patient and family hope for peace and dignity are supported throughout the course of illness, during the dying process, and after death.

Any individual with a serious illness, regardless of life expectancy or prognosis, can receive palliative care. Additionally, individuals who qualify for hospice service, and who are not emotionally ready to elect hospice care could benefit from these services.

Patients receive the following palliative services in any care setting:

  • pain and symptom management
  • in-person and telephone visits
  • help navigating treatment options
  • advance care planning and referrals to community resources.

Hospice care

Hospice care provides comfort through the end of life when the individual has a terminal prognosis and no further curative treatments are pursued. Hospice care focuses on the pain, symptoms, and stress of serious illness during the terminal phase. The terminal phase is defined by Medicare as an individual with a life expectancy of 6-months or less if the disease runs its natural course. This care is provided by an interdisciplinary team who provides care encompassing the individual patient and their family’s holistic needs.

Hospice should be considered at the point when the burden of any given curative treatment modalities outweighs the benefit coupled with prognosis. Other factors to consider and discuss, based on individual patient situations, are treatment modalities that no longer provide benefit due to a loss of efficacy.

It’s important to know that even if someone is placed on hospice care, s/he may be kicked off after the six-month period if their health improves. Sometimes it’s just a matter of that person beginning to eat and gain weight instead of refusing food and losing weight. An individual might go off and on hospice several times.

Patients receive the following services in most care settings including home, hospice facility, skilled nursing facility, long-term care facility, assisted living facility, hospital (inpatient levels of care only), group home:

Pain and symptom management

  • 24-hour on-call service
  • in-person visits
  • medical equipment
  • related medications
  • inpatient care
  • continuous care in the home
  • respite care
  • volunteer services
  • spiritual care
  • bereavement and counseling services

What you need to know about hospice

To initiate the process, a consultation for hospice and/or palliative care is initiated by the primary care physician or specialist, the patient, or a family member. The consultation is important to provide the patient and/or family with the services provided, as well as to verify that the patient qualifies for the services based on their current health status. If the person qualifies and desires the services their care provider issues a medical order. The hospice or palliative care provider then assigns an RN as the case manager who conducts an assessment of the patient. The patient’s needs are identified and a care plan is created.

  • Hospice does NOT provide round-the-clock caregivers.
  • If the patient gets better and gets off hospice care, s/he might re-qualify for services if they are needed in the future.
  • The patient doesn’t have to go off all their medications. For instance, if it’s flu season, and especially if the patient is in a care facility, s/he will probably still get a flu shot to reduce risk of getting sick and getting others sick. If the patient is on quality of life medications, those can be continued, as well as pain management medications. For the patient who has been on thyroid medications for decades, s/he will remain on those medications.
  • If the patient is uncomfortable with the visiting nurse or CNA, who usually provides personal hygiene a couple of times a week, a new visiting nurse health aid can be provided. The nurse coordinates the patient’s care plan so it’s important that the patient is comfortable with this person.
  • Hospice usually provides the following supplies: bed pads, adult diapers, wipes, barrier wipes/paste, non-latex gloves, wheel chairs, commodes, pressure pads, walkers, shower and transfer benches, air mattresses, hospital beds, bedside tray tables.

You will probably have a choice between a non-profit and for-profit hospice. Consult first with Medicare and your additional insurance provider or with Medicaid to see what is covered and which hospice affiliates they recommend. The Medicare Hospice Benefit pays all related costs associated with the care that is related to the terminal prognosis as directed by Centers for Medicare and Medicaid Services (CMS). Most private insurers have a hospice benefit that pays all related costs associated with the care related to the terminal prognosis. In most states Medicaid pays all related costs associated with the care related to the terminal prognosis as directed by CMS. In all cases, there may be some medications, services and/or equipment that are not included in the Medicare, Medicaid or individual’s policy, so don’t assume anything. Always ask.

Please remember that the more help you have in caring for your loved one, the more comfortable it will most likely be for you and your patient. This is usually one situation in which the adage “too many cooks in the kitchen spoil the stew” doesn’t apply. The more people you have on your caregiving team the better. And if your loved one has a terminal illness, the sooner you research hospice and palliative care the better. Don’t wait until an emergency arises and you are in a panic about helping your loved one. Don’t do it alone. Get help.

Blessings to you and your family.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

What if your dementia patient becomes abusive, aggressive or violent?

Angry, enraged senior woman yelling at a landline office phone, unhappy with customer service provided by the agent on the other side, giving off steam and smokeMy husband Morris was a gentle man. But occasionally, if things didn’t go his way, he would get nasty. Once Alzheimer’s took his brain hostage, he exhibited a darker side. But only when he was frustrated or confused.

Morris spent the last two years of his life in a memory care home. He was popular among the staff because he liked to goof around. When he walked the halls listening to music on his Walkman, he’d have a smile on his face and swagger to the rhythm. But if another resident got in his way, watch out. If it was crowded in the dining room and someone accidentally bumped him, he’d swing his arm out to shoo that person away. When one of his neighbors walked into Morris’s room mistaking it for his own, the two got into a rumble on the bed and fought like school boys. After this happened a couple more times, the neighbor was moved to the opposite side of the facility.

When Morris hit a resident in the dining room, the on-call physician prescribed a depressant to “calm him down.” Morris reacted to the drug by transforming into a zombie who slumped in his chair and slept too many hours during the day. I insisted that he get off the drug and Morris returned to his mostly cheerful self.

I once had a next door neighbor whose wife had Alzheimer’s. She threatened to kill her husband with a knife and then went on to slash a painting hanging in their living room. Was she or Morris responsible for their actions? No. A person with dementia is not responsible for acts of violence because as the disease progresses, neurons in the cortex that are responsible for language, reasoning and social behavior are destroyed. This leads to some Alzheimer’s patients engaging in aggressive or violent behavior such as biting, kicking, spitting, slapping, punching, and/or using foul language.

Research from the National Institutes of Health indicates that up to 96 percent of patients with dementia who were studied over a 10-year-period exhibited aggressive behavior at one time or other. In 2011, CNN Health reported that 5 to 10 percent of Alzheimer’s patients exhibit violent behavior at some point during the course of the disease.

There is usually a reason for aggressive behavior.

What to watch out for

  • Urinary tract infection
  • Pain or stress
  • Loneliness, depression
  • Too much noise or stimulation
  • Boredom
  • Constipation
  • Soiled diaper or underwear
  • Uncomfortable room temperature
  • Physical discomfort (stomach ache, etc)
  • Confusion
  • Anger about loss of freedom (to drive, living independently)
  • Drug reaction or contra-indication
  • Resistance against being told what to do such as bathing
  • Sudden change in routine, environment or caregiver
  • Communication problems
  • Hunger or not liking the food
  • Dehydration

What to do

  1. If your life or the life of the person you care for is in danger, get help immediately!
  2. The Alzheimer’s Association has a 24-hour helpline at 800-272-3900.
  3. Rule out UTIs, pain, discomfort, etc.
  4. Use an essential oil to help calm the person down. When my husband got agitated I’d put a few drops of oil on a cotton pad inside a diffuser and plug it into the wall. He usually calmed down immediately.  The following oils can be used in a diffuser, or put in a bath or fragrance free moisturizer. They can also be sprayed on a pillow or handkerchief. Citrus oils are generally refreshing and uplifting for the mind and emotions, relieve stress and anxiety, and are useful for odor management and appetite support. Consider: bergamot, grapefruit, lemon, and orange. Floral oils are often used as a personal fragrance and are useful to relieve anxiety, depression, and irritability. These oils are useful as an inhaler, in a body lotion, and for the bath. Consider: clary sage, geranium, lavender, rose, and ylang ylang. Tree oils are revitalizing with immune boosting properties, ease respiratory congestion, and are supportive to breathing ease. They are useful for pain relief, skin infections, and odor management, and can relieve nervous exhaustion and depression. Consider: eucalyptus (Eucalytpus citriodora or globulus), pine needle, sandalwood, or Tea Tree.
  5. Reassure your patient by speaking gently and calmly.
  6. Play calming music, i.e. Mozart
  7. Try to distract the person with a TV show, favorite snack (ice cream almost always works), or a walk outside.
  8. Maintain a regular routine.
  9. Make sure the lighting is suitable in the home or facility.
  10. Help the person to maintain as much dignity and independence as possible.
  11. Make sure the person is eating a nutritious low-sugar, low-salt diet, with no or very limited amounts of alcohol and caffeine.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.